This chapter distinguishes stressors, stress, and distress in the interest of bringing the use of these terms more into line with the way they are used in the stress literature and to reduce the problems of inconsistent usage prevalent in the discussion of stress in everyday life. It discusses two original stress models- biological and engineering. The chapter distinguishes varieties of stress, from life events to chronic to traumas to nonevents to daily hassles, at the individual level. It demonstrates that these distinctions are empirically supported by findings that different sources of stress have distinct impacts on mental health outcomes. The chapter discusses the issue of misconceptions about stress to argue that stress, although a general concept is a concept with theoretical and operational borders. It reviews trends in stress research, which reveal an upward trajectory in the study of all of the kinds of stress.

This chapter addresses public mental health interventions in the immediate phase following disasters and mass violence. Studies on the relative contribution of early arousal to subsequent post-traumatic stress disorder (PTSD), and the possible pharmacological strategies to reduce expressed adrenergic activity, suggest that the initial stress response is a necessary but insufficient cause of traumatic stress disorders. Social resources, such as social support, socioeconomic status, and access to services, have shown strong effects on mental health and played a variety of roles in the stress process. While offering cognitive-behavioral therapy (CBT)-based trauma-focused interventions may be helpful for some disaster survivors in the first month after the trauma, it may be lower on the hierarchy of needs for survivors faced with complex and chronic stressors. Further research into the needs of disaster-affected populations will help guide the timing of interventions, of both early and later-stage interventions after disasters.